1.What is hypertension?
Blood pressure refers to the lateral pressure of blood in a blood vessel for a unit area of the vessel wall, or pressure. The blood pressure is usually referred to as arterial blood pressure. When the ventricle is systolic, the aortic pressure rises sharply and reaches its highest value in the middle of the systolic period, when the arterial blood pressure value is called systolic pressure, which is also called “high pressure”. During ventricular diastole, aortic pressure decreases, and the lowest value of arterial blood pressure at the end of diastole is called diastolic pressure, or “low pressure. Hypertension refers to an increase in blood pressure in the arteries of the body circulation and is a common clinical syndrome, which can also be said to be a systemic disease characterized by increased systolic and diastolic blood pressure, often accompanied by functional or organic changes in the heart, brain, kidney and other organs; the disease can be caused by a variety of pathogenic factors and complex pathogenesis, central nervous system dysfunction, endocrine genetics, abnormalities in the function of renal and cerebrovascular pressure receptors, as well as cell membrane ion transport Abnormalities in cell membrane ion transport can lead to hypertension.
2.Harm of hypertension
According to China’s statistics, the incidence of hypertension in China’s 35- to 74-year-old population is as high as 27%, and the number of patients is close to 130 million, with more than 3 million new cases each year. The mortality rate of cardiovascular diseases caused by hypertension has ranked first in the mortality rate of all diseases.
Heart: coronary artery disease, left ventricular hypertrophy, heart enlargement and heart failure.
Brain: transient ischemic attacks, strokes (ischemic and hemorrhagic).
Kidney: small renal artery sclerosis, renal atrophy and renal insufficiency.
Peripheral vascular: atherosclerosis.
Eye: fundus hemorrhage, blindness.
3.What people are prone to hypertension?
The following groups of people are at high risk of hypertension.
(1) Those whose parents have hypertension.
(2) Those who consume more salt.
(3) Those who consume more animal fat
(4)Those who drink alcohol for a long time.
(5) Those who are mentally stressed.
(6) Smokers, obese people.
(7) High cholesterol, heart or kidney disease, diabetic patients.
4.The classification of hypertension
(1) primary hypertension: also known as hypertension, may be caused by genetics, smoking, alcohol, excessive salt intake, overweight, mental stress, lack of exercise and other factors, accounting for more than 90% of all hypertensive patients. At present, it is difficult to cure, but can be controlled.
(2) Secondary hypertension: there is a clear cause of elevated blood pressure, accounting for 5-10%. The common causes of secondary hypertension are:, renal lesions (such as acute and chronic glomerulonephritis, pyelonephritis, renal artery stenosis, etc.); multiple aortitis; gestational hypertension syndrome; endocrine diseases (such as pheochromocytoma, primary aldosteronism, etc.);, pharmacogenic factors (such as long-term oral contraceptives, long-term application of hormones), etc.
5.What are the symptoms of hypertension?
Hypertension usually has no symptoms, a few people may have symptoms such as dizziness, headache or rhinorrhea. The presence or absence of high blood pressure or the degree of elevated blood pressure is not parallel to the presence or absence of symptoms or the degree of symptoms. Many patients do not feel discomfort even if they have had hypertension for many years or even if their blood pressure is very high. Therefore, the greater danger of hypertension is that it is a “silent killer”, so most hypertension is detected during a physical examination or a visit to the doctor for other diseases. Once found, regardless of the severity, should be treated as soon as possible.
6.What are the diagnostic criteria for hypertension?
In 1999, the World Health Organization/International Hypertension Society (WHO-ISH) guidelines for the treatment of hypertension established new diagnostic criteria and classification for hypertension in people over 18 years of age (see Table 1 below).
7.Treatment of hypertension
Treatment goals: long-term, effective control of blood pressure (short-term goals); prevention (reversal) of damage to target organs such as the heart and kidneys (long-term goals); reduction of morbidity and mortality from cardiovascular and cerebrovascular diseases (long-term goals). The systolic and diastolic blood pressure should be reduced to below 140/90 mmHg in all general sick people, systolic blood pressure should be reduced to below 140 mmHg in elderly patients, and in hypertensive patients with diabetes or kidney disease, the goal of blood pressure reduction is below 130/80 mmHg.
(1) Non-pharmacological treatment
Every patient with hypertension needs to receive non-pharmacological treatment i.e. lifestyle improvement, regardless of whether they receive medication or not. For some patients with mild cases doctors may recommend non-pharmacological treatment first for a period of time to see if they can lower their blood pressure.